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Your Details

First Name:

*required

Surname:

*required

Address 1:

*required

Address 2:

Town/City:

*required

Postcode:

*required

Tel:

Mobile:

*required

Fax:

Email address:

*required

Your Target AREAS

Please indicate
which of our standard regions that
you target in your agency activities.*required

UK & IRELAND

To view the regions rollover the map below.

Then select your region(s) from the checklist on the right

Select as many as needed to reflect the area you cover or are prepared to cover.

Please select any and all regions that you cover, even if only partially.

Please note that regions are based on postcode areas and not counties. The map shows the counties of the UK with the postcode regions overlaid in yellow. And there is a degree of overlap between some regions.

Scotland

Northern Ireland

Republic of Ireland

North

North East

North West
(inc. N. Wales)

South West
(inc. S. Wales)

London

South East
(inc. London)

South Midlands

East Midlands

West Midlands
(inc. Mid Wales)

East

South

All UK

Do you cover the UK only or UK & International:

UK Only
UK & International

*required

Europe:

Albania

Germany

Norway

Andorra

Greece

Poland

Armenia

Hungary

Portugal

Azerbaijan

Iceland

Romania

Belarus

Italy

Russia

Belgium

Kazakhstan

San Marino

Bosnia & Herzegovina

Latvia

Serbia

Bulgaria

Liechtenstein

Slovakia

Croatia

Lithuania

Slovenia

Cyprus

Luxembourg

Spain

Czech Republic

Macedonia

Sweden

Denmark

Malta

Switzerland

Estonia

Moldova

Turkey

Finland

Monaco

Ukraine

France

Montenegro

Vatican City

Georgia

Netherlands

Rest of World:

Africa

Asia

North America

South America

Oceania

Further information about your AREA:

Please tell us more about the geographical area that
you cover.
For example anything that you cannot express using our
standard categories above.

Your MARKET SECTORS

Please tick
the standard market sectors that
you cover, or that you're interested in, below.

You may
select any and all markets that you cover, even if
only partially. (10 max)*required

Architects / Surveyors / Interior Designers

Jewellers

Bakers / Butchers

Kitchen Specialists

Booksellers

Leather / Travel Goods

Builders / Decorators Merchants / Building Contractors

Legal: Solicitors And Barristers

Camping / Outdoor Leisure / Fishing / Equine

Leisure Centres / Gyms / Health Clubs

Cash & Carry / Wholesale / Distributors

Local Government Authorities

Chemists / Pharmacy / Drug

Mail Order

Clothing / Fashion / Textile

Marine Chandlers

Computer Suppliers

Motor Accessories

Cook Shops

Music / TV / Publishing / Media

Corporates / Offices

New Age Retail

CTN (Confectioners, Tobacconists, Newsagents)

Nursing / Residential Homes

Dentists / Doctors / Vets

Off Licences And Wine Merchants

Direct Selling (Householders)

Pet Retail / Wholesale

Discount / Pound Shops

Photographic / Camera

DIY / Hardware / Ironmongery

Post Offices

Drapers / Haberdashers

Printing & Graphics

Electrical Goods / Lighting / Electronics / Telecom

Private Training / Educational

Engineers / Consulting Engineers

Pubs / Clubs

Estate Agents

Restaurants / Caterers / Hotels / Cafes / Snack Bars

Fabrics / Linens / Soft Furnishings

Schools / Colleges / Universities / Education Authorities

Factories / Engineering / Manufacturing / Industrial

Security

Footwear

Sports Goods / Sportswear

Furniture / Upholstery

Stationers

Garages / Motor Repairs / Car Sales

Supermarkets / Multiples

Garden Centres / Florists / Horticulture

Timber Industry

Gift / China / Glass / Cards / Department Stores

Toys, Novelties, Hobbies

Golf Clubs

Visitor Centres / Tourist Attractions

Grocers / Convenience Stores / Petrol Stations / Delicatessens

Logistics

H.M. Forces

Arts / Crafts / Galleries

Hairdressers / Beauty & Tanning Salons

Financial Services

Health Food Stores

Opticians

Hospitals

Childcare / Nurseries / Playschools

Housewares / Homestores

Internet / Web

Further information about your MARKETS:

Tell us anything that you cannot express using our
standard categories above.

Your
PRODUCTS and/or SERVICES

Please tell
us about what you currently sell, and/or what you
are looking for.

Products / services carried now:

Products / services sought:

(What are you looking for?)

Your EXPERIENCE

Please tell us a little about your activities as a self-employed, commission-only sales agent.

When did you first become an agent?(eg. 2008)

Number of active customers:

Previous products / services sold:

My past or other experience

Please tell
us about your other / previous relevant experience
and skills.

(I.e. before you were an agent, or other current business
activities such as franchises, distributorships, etc)

Sales experience (give details, include nature and number of years): *required